What is PFS?

What is Post-Finasteride Syndrome?

icon_111Finasteride is the the ingredient in Propecia / Proscar.  It is used for treating male pattern hair loss. Some people seem to get negative side effects for unknown reasons. Millions of people around the world take Finasteride daily with just insignificant symptoms. Some lucky ones even have zero side effects. Then there are numerous thousands of men who get extreme reactions. Some even by just taking a few pills. In other cases, a fraction seem to do well on Finasteride and suddenly, they get heavy reactions even when they have NOT had side effects for many years of .

Post-Finasteride Syndrome (PFS) was coined because what is very unique to PFS is that the side affects last after stopping the pill. Many men have complaints for years after they quit taking the pill.

What Finasteride does

Finasteride works against hair loss by decreasing the levels of 5a-reductase, an enzyme which is involved in steroid metabolism. Products of its enzymatic reaction include testosterone, progesterone, androstenedione, epi-testosterone, cortisol, aldosterone, and deoxycorticosterone. 5α-reductase inhibition is best known for preventing conversion of testosterone to the more potent dihydrotestosterone (DHT) in androgenic disorders.

Many men have completely normal profiles,

Do you experience symptoms ?

Neurological SymptomsSexual SymptomsPhysical Symptoms
Neurological SymptomsSexual SymptomsPhysical Symptoms
Feelings of isolation and seperation Loss of sexual interest, lack of sexual thoughts. Gynecomastia (abnormal growth of breasts in men)
Extreme brainfogLoss of erotic dreamsMuscle spasms
Loss of joy and positive feelingsErectile dysfunction; ImpotenceLower back pain
Not being able to process emotions ( e.g. not being able to grief)Loss of morning erectionsweak knees
Loss or decrease in memory capacityLack of spontaneous erectionSunken and/ or dry eyes
Cognitive difficulties Loss of sensation in the penisFatigue, constant tiredness
Slurred speech (less common)Decrease in the size of the testiclesDry skin
RestlessnessPain in testiclesJoint pain
Extreme anxiety, panic attacksDecreased volume of ejaculateDigestive problems
Loss or reduction of REM sleep stage (no dreams, lighter sleep)Watery ejaculationConstant head pressure
Narrow focusLoss of intensity in orgasmFood sensitivities ( reduced ability to digest
Depression, melancholy,Difficult to achieve orgasmBloated belly
Extreme anxiety, panic attacksHypoglycemia

My history of PFS

I have suffered from most of the above symptoms for nearly 8 years. My complaints revolved around brainfog, headaches, fatigue/low stress tolerance and allergies. After seeing many different doctors from around the world, I came to the conclusion that my symptoms were mostly due to very weak adrenals, low oxygenation of the blood, dysbiosis, and emotional trauma.
 I can attest the enormous pain PFS is causing men. Almost the 1 quarter of my life consisted only of trying to figure a way to deal with my symptoms. Before I didn’t know how to feel better, my life was a daily battle for survival.
A quantum leap occurred the time I learned about the idea that were are electrical beings. Meaning, that all our biochemical behaviors, the preservation of and integrity of our cellular structures depend on electrons in our cells. I started to look in terms of electrochemical potential and what I can do to change my inner pH balance within the fluids inside and outside my cells. In essence, I followed the idea to correct my electrochemical environment to the entirety  so the intricate biochemistry can proceed unhindered. Many steps were incorporated:
  •  through diet,
  • detoxification,
  • through balancing stress,
  • living according to natural laws and rhythms, proper sleep
  • restore colon flora
  • cultivating a loving attitude to yourself and others,
  • oxygen supplements, qi gong and social activities, family
 An electron rich bod encourages oxygen to penetrate cells, prevents junk molecules from sticking to cell membranes and DNA base pairs, vanquishes pathogens and powers our immune cells.

The way PFS affects the body

There are many studies confirming the side effects Finasteride is causing to men. However, it is very difficult according to present research to clearly determine what Finasteride exactly does to our bodies. There are several scientists suggesting it mainly is due to the drugs altering effects on the metabolic and endocrine systems.

Here are excerpts from 2 studies,

“… the most important finding was the comparison of their neuroactive steroid levels with those of healthy controls. Indeed, decreased levels of tetrahydroprogesterone, isopregnanolone and dihydrotestosterone and increased levels of testosterone and 17β-estradiol were reported in cerebrospinal fluid of postfinasteride patients. Moreover, decreased levels of dihydroprogesterone and increased levels of 5α-androstane-3α,17β-diol and 17β-estradiol were observed in plasma. The present observations confirm that an impairment of neuroactive steroid levels, associated with depression symptoms, is still present in androgenic alopecia patients treated with finasteride despite the discontinuation of the treatment.” (1)

“In a group of 61 otherwise healthy former users of finasteride who developed persistent sexual side effects, depressive symptoms were present and categorized as mild in 11% of users, moderate in 28% of users, and severe in 36% of users. Suicidal thoughts were present in 39% of former finasteride users, and an additional 5% chose the statement “I would like to kill myself.” (2)

“A plausible biological mechanism to explain the association between finasteride and depression lies with neuroactive steroids, neuromodulators that are synthesized in the central nervous system itself and that are also transported to the brain from the gonads and adrenal glands.” (2)

 

Hormones tests are often quite regular desit the person affected suffers tremdnously.

Hormones, enzymes and neurotransmitters related to PFS:

  • Low-normal /hypogonadal levels of testosterone, both total & free. Below what would be expected for the patient’s age
  • Low LH & FSH, Similar to secondary hypogonadism when diagnosed in combination with testosterone
  • Many show a high level of Estradiol/Estrone
  • TSH – Some patients also have changes in TSH. There are cases where the Post-Finasteride Syndrome induced hypothyroidism. However, it is not most cases.
  • Low/below range 3alpha-androstanediol glucuronide (3a-Diol-G), a hormone derived from DHT (the hormone inhibited by finasteride).
  • Various other imbalances including elevated liver enzymes (ALT, AST) etc.
  • Effects on DHEA-S,  SHBG, Prolactin and Progesterone
  • Excess Cortisol release
  • Cortisol (along with its partner epinephrine) is best known for its involvement in the “fight-or-flight” response and temporary increase in energy production.
    They report very high stress symptoms, which often develops into an episode of panic attack or anxiety attack
  • Vitamin-D – Many PFS patients have low levels of Vitamin D.

A Chinese perspective

articles-12-primary-channels-part-1-1When we explore Chinese Medicine, we will come in contact with the idea of “essence” aka jing.

In opposite to Western medicine, Chinese medicine is not looking at so much at your neurotransmitters or hormones. The vitality of the body is judged not just by purely physical data, but also in ways of energetic connections between different meridians and life force as well.

In Chinese medicine, there are essential 3 energetic systems that make up the human constitution. They are called jing, chi and shen, also known as the Three Treasures.

Each energy has unique qualities and is responsible for different parts in body, mind and spirit. When it comes to PFS, most important is the jing. As essence, it determines our physical constitution, bone density, immunity, quality of semen, to name a few – particularly qualities that are damaged during PFS.

Research papers 

1.) Neuroactive Steroid Levels are Modified in Cerebrospinal Fluid and Plasma of Post-Finasteride Patients Showing Persistent Sexual Side Effects and Anxious/Depressive Symptomatology

http://onlinelibrary.wiley.com/doi/10.1111/jsm.12269/abstract

2.) “Depressive Symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects”

http://article.psychiatrist.com/dao_1-login.asp?ID=10007988&RSID=16409503147040

3.) Depression circumstantially related to the administration of finasteride for androgenetic alopecia

http://www.ncbi.nlm.nih.gov/pubmed/12433001?dopt=Abstract